Introduction

Health literacy is a crucial element to realise the Sustainable Development Goals, and a response is needed that goes beyond the health sector. Countries, organisations and communities need to take action, collaborate and support knowledge and learning about health literacy on all levels. Communities of practice (CoPs), where people share and develop knowledge, are a promising and commonly used tool to support these processes, yet little empirical data exist on how to set them up to ensure their utility. Spontaneously, bottom-up, evolved CoPs may not be specifically deployable as a knowledge tool, as they run their own agenda. Purposefully, top-down, established CoPs often struggle with issues such as trust, participation, support, and satisfaction. In our research we explore a way to capitalise on the advantages of both approaches by co-designing CoPs to focus on advancing health literacy.

Methods

We used contemporary co-design approaches in health to develop this co-design approach for CoPs. Preparation starts with exploring how the context of CoPs triggers certain mechanisms that advance health literacy. Exploration is followed by a needs assessment, focussing on the aims, expectations and previous experiences of members of the CoPs. Outcomes from the exploration and needs assessment form the plan about how to start and run CoPs. Outcomes and plans are shared between members and are continuously amended consistent with co-design principles.  

Results

Initiators of CoPs indicate an initial co-design exploration is helpful for starting CoPs. Results from the needs assessments indicate different expectations from members versus initiators. Members signify they like to start with increasing their own individual knowledge before contributing to an overarching aim. Members have high expectations from a facilitator and other members, yet they often marginalise their own role. Participation in previous CoPs brings positive and negative experiences, resulting in recommendations for organising and structuring CoPs.

Discussion

The co-design process has supported the process of establishing CoPs that are actively focussing on the aims of the initiator and members. How co-design affects outcomes of advancing health literacy, is ongoing and implemented through a practical manual.